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Minister: ex-Healthcare Minister should admit her mistake and apologize to residents

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Baltic news, News from Latvia, BNN.LV, BNN-NEWS.COM, BNN-NEWS.RUInstead of making sharp remarks about health insurance reform, Latvia’s ex-Healthcare Minister Anda Čakša should simply apologize and admit that the health insurance system, which is put on hold until 1 July, is unfair and discriminating – it divides people based on their taxpayer status, said Latvia’s current Healthcare Minister Ilze Viņķele in an interview to BNN.

«I apologize – this is the purest constitutional risk»

Viņķele stresses that one of the most important tasks ahead for Latvia’s Healthcare Ministry is fixing Čakša’s rejected offer, which is the objective the ministry has received from the Saeima.

«Healthcare is one of the most influential factors in inequality indexes. This is why I wind it critically important to fix the unfair health insurance system, because it affects poor people the most. I hope that by addressing this issue we will at least avoid increasing inequality indexes,» says the healthcare ministry.

Viņķele explains that the problem with Čakša’s offered reform is that under the general regime working people will be given one percentage point of social insurance fee. Those employed in micro-enterprises and pay social fees will not get this percentage point – they will have to cover EUR 250 a year on their own.

«I apologize – this is the purest constitutional risk! Had this law come to force, people would have turned to the Constitutional Court with complaints about discriminatory attitude towards people employed in micro-enterprises. In Čakša’s case, I would keep quiet about constitutional risks,» Viņķele comments on Čakša’s previous statements in regards to the new healthcare minister’s health insurance reform, referencing possible constitutional risks.

Viņķele also says the practice common around the world is when people with insurance receive what the state can provide. Those who do not have insurance receive emergency medical assistance. «This is not about two baskets. This is one whole basket,» stresses the minister. She says that during the presentation of this model to Latvian Employers’ Confederation and transition to a single basket, Latvian Hospital Association mentioned wanting to hear this announcement from the moment of the law’s approval, because it lifts from doctors’ shoulders the unpleasant burden of having to divide people and deny them services.

There is a feeling that the winner of e-health third stage was known before tender’s initial announcement

As for the third stage of Latvia’s electronic state healthcare system or e-health, which provides for considerable modernization and improvements, including tying it to personal identification, Viņķele did not deny having concerns regarding the transparency of the procurement process.

BNN had previously reported that the third stage of e-health development was put on hold to further outline planned activities and priorities.

«I have serious doubts if the third stage of the procurement is evaluated based on the usefulness of what the state is plans to procure. Will we pay exactly as much all of it costs without the risk of overpaying? And what about the possibility of ‘finding’ the winner of the procurement before it is even announced? Once we achieve clarity for these three questions, the e-health system’s third stage will be ready to go,» Viņķele comments on the situation.

She also notes that answers should be found in very tight terms to make sure Latvia does not lose money provided by the EU. Healthcare Ministry is committed to resolving the issue within a month.

At the same time, Viņķele stresses the previous Healthcare Ministry had commenced some good deeds: «There is the reduction of medication prices, positive progress in discussions with medicine manufacturers for a number of medicines, and grading hospitals.»

Eight million – possible amount Latvian residents overpay when buying original medicines instead of cheaper alternative medicines

It has been found in Latvia that medicine wholesale traders sell products outside of Latvia. As a result, situations appear when patients eligible for medicines with 100% compensation are unable to receive them because pharmacies simply do not have them in stock. This also means those patients are forced to buy other types of medicines.

Viņķele promises to change the situation. She says to fix this situation, Healthcare Ministry has come up with amendments to regulations that make it compulsory to declare medicine stores every day. «It will be necessary to detail names of medicines and their stored amount so that State Agency of Medicines is able to control availability of medicines on the market more flexibly.»

The coalition and opposition agree prices for medicines in Latvia are too high. Viņķele told BNN that the statement that medicines in Latvia are more expensive than elsewhere is not exactly true because medicine prices vary depending on the size of the market, licenses and other reasons.

As for people comparing prices of medicines in Latvia and Lithuania, the minister said the following: «There are medicines that are cheaper in Latvia than they are in Lithuania. This is not absolute. People do not generally care how much something costs elsewhere, rather how much they have to pay on medicines in general.»

When asked what has been done so far to reduce patients’ costs on medicines, which was one of Viņķele’s pre-election promises, the minister said the following: «We have prepared a pharmaceutical package, as we call it in the ministry. We have made several amendments to the Pharmaceutical Law, Cabinet of Ministers requirements with one goal in mind – increase competition on the medicines market and reduce costs for patients. One of the new requirements will be stating names of internationally non-patented medicines in prescription orders.»

Viņķele stresses that people in Latvia generally overpay around EUR 8 million for original medicines even with cheaper alternatives available.

When asked if alternative medicines are just as efficient as original medicines and do not have negative side-effects, Viņķele said: «There is also the possibility of side-effects. It is also clear there are situations when original medicines are needed. Doctors are able to tell if medicines have a possibility of causing side-effects for patients. Use of alternative medicines is not something unique to Latvia – the whole world is moving towards this practice.»

Hoping to get amendments through the Saeima before summer break

Viņķele doubts Latvia’s healthcare budget will reach 4% of GDP next year. «This means society will have to put to rest the deam for sufficient funding and accessible healthcare.»

As for this year’s budget, the minister says the country’s healthcare industry cannot complain about not being heard.

«There is money to afford increasing wages and increasing the number of medical examinations and consultations. There is also EUR 3 million available to treat rare diseases. I would also like to stress the EUR 6 million to resolve the problem of mental health. This means we can reanimate a basically dead industry not often mentioned in Latvia. This includes accessibility of compensated medicines for people suffering from mental problems, which is very important.»

As for the general budget of Latvia’s healthcare budget, Viņķele stresses: «Reality is that there was a generally dismissive attitude from the state. This includes politicians. Basically they understand things are bad, but looking at the budget – not so much.»

As for what Latvia’s healthcare system can do and how quickly, Viņķele said she hopes it is possible to fix the country’s healthcare insurance system and pull amendments through the Saeima before the summer break.

«This would mean amendments come to force 1 January 2020. I hope we are able to appoint professional university hospital councils by autumn, which would be a big step forward for sorting large hospitals and ensure fair and transparent procurements.»


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